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The Medical Society represents the physicians and patients of the District of Columbia in discussions with the City Council, the DC Departments of Health and Behavioral Health, the DC Boards of Medicine and Pharmacy, plus other members of the medical community. Since the DC Council held its first legislative meeting at the beginning of the year, the Medical Society has been reviewing numerous healthcare bills and is working with key stakeholders on multiple fronts. See below for an overview of legislation and see "How a (DC) Bill Becomes a Law" for an overview of DC's policy-making process.

22nd Council Period (January 2017 - Present)

Legislation passed with support from MSDC

B22-0106: Defending Access to Women's Health Care Services Amendment Act of 2017(Official Law effective March 28, 2018)BILL SUMMARY - As introduced, this bill requires insurers to cover certain health care services without cost-sharing including breast cancer screening and counseling, screening for HIV and counseling for sexually transmitted infections. It also requires insurers to provide information regarding coverage to enrollees and potential enrolleeSTATUS: The Council held a Public Hearing on March 20, 2017. The bill was approved and Act A22-0246 was published in DC Register on February 9, 2018. It went into effect as Law Number L22-0075, effective from March 28, 2018. Previously, emergency legislation was enacted with Act Number A22-0049 on April 24, 2017.

B22-0177:Interstate Medical Licensure Compact Approval Act of 2017 (Official Law effective Jun 5, 2018)BILL SUMMARY - As introduced, this bill establishes eligibility requirements for physicians to receive or renew an expedited medical license to practice medicine in multiple states and to share information with other member states to streamline the licensing process. It establishes the Interstate Medical Licensure Compact Commission and authorizes the Mayor to join the Interstate Medical Licensure Compact (The Compact).STATUS: The Council held a Public Hearing on December 6, 2017. The bill received unanimous approval at its first reading on February 6, 2018 and continued strong support. The legislation was enacted on April 6, 2018 and has been transmitted to Congress. It went into effect as Law Number L22-0109, effective June 5, 2018.MSDC ACTION: MSDC has long-standing policy supporting The Compact and has submitted a letter in support of the Compact.

B22-0524: Maternal Mortality Review Committee Establishment Act of 2017BILL SUMMARY - As introduced, this bill establishes the Maternal Mortality Review Committee within the Office of the Chief Medical Examiner to determine the causes associated with maternal deaths in the District and find solutions to lower the maternal death rate and improve maternal health. The Board is required to submit an annual report of findings, recommendation, and steps taken to evaluate implementation of recommendations, to the public, the Mayor, and the Council of the District of Columbia. It also gives the Committee the authority to seek information from entities and agencies inside and outside the District of Columbia including medical records.MSDC ACTION: Support. See MSDC's letter of support.STATUS: The bill received a Public Hearing on December 7, 2017. The bill passed the Council in March and was transmitted to the Mayor. It became Law L22-0111 effective June 5, 2018.

Access to Care

MSDC believes that DC residents should be able to access appropriate care regardless of location or background. The following are some of the issues we are following this Council session:

BILL SUMMARY: As introduced, these bills would limit the sale of short-term, limited duration health insurance plans and ensure multiple employer welfare arrangements are covered by small employer market rules.

MSDC ACTION: MSDC supports this legislation and submitted a letter of support in partnership with 20-plus consumer health stakeholders.STATUS: The Committee on Health held a hearing on the legislation in November 2018 and is advancing compromise legislation, both permanent and emergency bills, this year. B22-1001 is expected to pass before the end of the Council session.

BILL SUMMARY: As introduced, the bill would permit the State Health Planning and Development Agency to approve or disapprove the closure or termination of services of any health care facility.

MSDC ACTION: MSDC is monitoring this legislation for its impact on DC physiciansSTATUS: The emergency version of this bill was signed into law by the mayor this fall. Permanent legislation is being considered.

::VICTORY:: B22-0597: Behavioral Health Parity Act of 2017
BILL SUMMARY - As introduced, this bill requires all health benefit plans offered by an insurance carrier to meet the requirements of the federal Paul Wellstone and Pete Domenci Mental Health Parity and Addiction Equity Act of 2008. It requires all plans to submit an annual report to the Department of Health Care Finance on or before October 1 of every calendar year. MSDC ACTION: Support. See MSDC's letter of strong support

STATUS: The bill passed its first reading by the Council in November 2018 (see Committee on Health report here). The bill was passed by the Council on December 4 and is awaiting the mayor's signature.

B22-0657: School Sunscreen Safety Amendment Act of 2018BILL SUMMARY: As introduced, to amend the Student Access to Treatment Act of 2007 to permit students to possess and self-administer sunscreen while at school, traveling to school, or on a school-related trip without a medication action plan, to train employees and agents of a school to administer sunscreen, to permit trained employees and agents of a school to administer sunscreen to students .MSDC ACTION: MSDC wrote a letter supporting the bill and urging a Public Hearing.STATUS: A Public Hearing has not yet been scheduled.

BILL SUMMARY: As introduced, thebill helps expedite the process of building a new hospital run by GW on the St. Elizabeth's campus.

Status: Currently under consideration by the whole Council. See the Committee on Health report here.

B22-0207: East End Health Care Desert, Retail Desert, and Food Desert Elimination Act of 2017BILL SUMMARY: As introduced, this bill requires the Department of Health Care Finance to establish a new capital project, the East End Medical Center (to be constructed on the Saint Elizabeths East Campus), and provides for its funding, operation, and maintenance. The bill also establishes a special fund, the East End Medical Center Fund and program, the East End Grocery and Retail Incentive Program. The fund shall be administered by the Department of Health Care Finance.STATUS: The bill was referred to the Committees on Health and Committee on Business and Economic Development. The Council held a Public Hearing on May 19, 2017. In June 2017, D.C. Council's six-year capital spending plan allocated funding toward a proposal to build a medical center in the East End. The bill was marked up and the Committee Report was filed. The bill remains under Council Review.

B22-0558: Community Health Investment Amendment Act of 2017BILL SUMMARY: As introduced, this bill requires health care facilities to add community benefits - health improvement services and benefits that are provided without charge - as a prerequisite to obtaining or maintaining a certificate of need. The community benefits must be made specifically available to District residents.STATUS: The bill received a Public Hearing on July 11, 2018 and was marked-up by the Committee on Health November 28. The bill is up for Council consideration before the end of the session.

B22-0689: Omnibus Assisted Living Residence Improvement and Quality Long Term Care Act of 2018
BILL SUMMARY: As introduced, this bill establishes standards for Department of Health inspection of resident files and resident agreements. It establishes the right to civil action against an Assisted Living Residence (ALR) for violations. It requires an ALR to develop policies for daily operations, treatment plans, grievances and emergencies. It requires certain staff to resident ratios. It sets standards for transfer and discharge of residents and establishes a resident's absolute right to reside in and have access to one's living unit at all times. STATUS: A Public Hearing was held on June 22, 2018. See video.

B22-0690: Study of Long-Term Care Services and Supports Act of 2018BILL SUMMARY: As introduced, this bill requires the Department of Health to conduct a study to evaluate availability of affordable long-term care facilities, services and supports for residents of the District of Columbia. Among other things the study will provide a projection of the number of DC residents who will require facility-based and home and community-based long-term care services over the next 10 years and provide any recommendations deemed appropriate for the development of needed service capacity. STATUS: A Public Hearing was held on June 22, 2018. See video.

BILL SUMMARY: As introduced, the bill would provide a new DC agency the authority to refinance and provide new student loans to DC students and residents.

MSDC ACTION: MSDC is monitoring for potential support based on the applicability of the program to DC medical students.

STATUS: The bill was introduced by CM Silverman on October 16, 2018. It was referred to the Committees on Education and Finance & Revenue.

B22-366: Health Care Reporting Amendment Act of 2017BILL SUMMARY: This bill requires an employer of a health professional to submit a written report, within 10 days, of any action taken against a health professional due to incompetence, mental or physical impairment, and unprofessional, illegal or unethical conduct. It also requires health professionals to report disciplinary action taken against them in another state and any malpractice suits filed against them. STATUS: The bill was introduced by Chairman Mendelson at the request of the Mayor on June 26, 2017. The bill was referred to the Committee on Health and a Public Hearing took place on October 25, 2017.

B22-0688: The Athletic Trainers Clarification Amendment Act of 2018BILL SUMMARY: As introduced, this bill allows athletic trainers to diagnose physical disabilities and to rehabilitate injuries resulting from concussions. It expands the scope of injuries that can be treated by athletic trainers and expands available methods of treatment. It increases the membership of the Board of Physical Therapy from 7 to 10. It allows the Mayor to waive requirements regarding the education of audiology and speech language pathology and licensure for one year for those with 5 years of school-based speech language pathology experience.STATUS: A Public Hearing was held on June 22, 2018. See video.

Opioid/Drug Policy

MSDC joins theAmerican Medical Association, the Department of Health, and all DC government officials in its desire to see an end to the opioid epidemic in this city and nationwide. Below are some of the bills the Society is following:

B22-458: Opioid Overdose Prevention Act of 2017BILL SUMMARY - As introduced, this bill requires the Metropolitan Police Department (MPD) to provide opioid rescue kits, for those that qualify, to prevent potential overdose deaths. The rescue kits include overdose education materials that conform to specific guidelines for overdose education that explain the signs and causes of an opioid overdose and instructions on when and how to administer life-saving rescue techniques. MPD is required to train qualified personnel and allow for voluntary surrender of opiates and drug paraphernalia at MPD stations.STATUS: A Public Hearing took place on December 12, 2017.

B22-459: Opioid Abuse Treatment Act of 2017BILL SUMMARY - As introduced, this bill requires health plans to transmit a list of the contact information of all in network providers that treat opiate use disorders. It requires the Department of Health Care Finance to determine the feasibility of expanding opioid use disorder medications offerings in methadone clinics and on appropriate reimbursement rates for treatment. It requires training for certain opioid prescribers. It requires continued treatment upon an addicted inmate entering a Department of Corrections facility. It creates a fatality review team at the Department of Behavioral Health to review overdose deaths. It requires hospital's to establish discharge protocols for individuals identified as having a substance abuse disorder. STATUS: A Public Hearing was held on December 12, 2017. The bill is under Council Review. While it is expected to pass before the end of the session, it has undergone some changes in the Committee on Health.

B22-0583: Opioid Abuse Prevention Amendment Act of 2017
BILL SUMMARY - As introduced, this bill limits initial prescription of opiates for acute conditions to seven days or less. It establishes requirements for subsequent prescription of opiates. It establishes limits to the strength of opiates that are not prescribed for acute conditions. Among other things the Mayor is required to issue rules to limit and track the dispensing of opiates prescribed out of state. MSDC ACTION: MSDC recommended the Council assemble a work group or task force of clinicians, pain management specialists and addiction experts. STATUS: A Public Hearing took place on February 12, 2018.

Public Health

The following are some of the public health bills MSDC is following this session:

B22-0480: Vulnerable Population and Employer Protection Amendment Act of 2017BILL SUMMARY - As introduced, this bill authorizes a health occupations board to discipline a health professional who has financially exploited a patient, client or employer and provides for the summary suspension or restriction of the license, registration, or certification of a professional who financially exploits another without a hearing.STATUS: A Public Hearing will take place on July 11, 2018.

B22-0666: Women, Infants, and Children Program Expansion Act of 2018BILL SUMMARY: As introduced, this bill prohibits the Mayor from placing restrictions on the square footage, number of cashiers, or organic products for vendors of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) beyond what is required by federal law. Among other things it requires the Department of Health to convene a WIC Outreach Advisory Board to provide guidance on how to increase WIC participation
STATUS: The bill received a Public Hearing on July 11, 2018

B22-0687: Adverse Childhood Experiences Task Force Act of 2018BILL SUMMARY: As introduced, this bill establishes an Adverse Childhood Experiences Task Force to study policies and practices in pediatric settings designed to mitigate conditions arising from toxic stressors and adverse childhood experiences.STATUS: The bill received a Public Hearing on July 11, 2018

Scope of Practice

The following are some of the scope of practice bills MSDC is following this session:

B22-333: Advanced Practice Registered Nurse Signature Authority Amendment Act of 2017BILL SUMMARY: As introduced, this bill enables advanced practice registered nurses to sign, certify, stamp, or endorse all documents related to healthcare within their scope of practice. STATUS: The bill was passed and transmitted to the mayor on December 11, 2017, which she signed. Law L22-0060 went into effect in February 2018

B22-0744: Optometry Practice Amendment Act of 2018BILL SUMMARY: As introduced, this bill permits optometrists to prescribe certain analgesics included in Schedule II through V controlled substances for the treatment of diseases of the human eye and its adjacent structures. Optometrists are no longer required to consult with a medical provider prior to treating glaucoma. MSDC ACTION: MSDC opposes the bill.STATUS: The bill received a Public Hearing on July 11, 2018, and the Medical Society submitted a letter of opposition for the public record.

Women's Health / Maternal Health

The following are some of the bills MSDC is following this session involving women's health, maternal health, and reproductive issues. See above for our legislative victories in this area:

BILL SUMMARY: As introduced, the bill requires health care facilities to notify patients of mammogram results tending to show high breast density with explanatory language, and requiring insurers to cover certain health-care services without cost-sharing.

MSDC Position: MSDC has submitted comments with recommendations to improve the legislation, while supporting the intent of the bill.

STATUS:The Committee on Health reported the bill from committee (see report here) and the Council passed the legislation without MSDC's suggested changes on December 4.

B22-784: Certified Professional Midwife Act of 2018BILL SUMMARY: As introduced, this bill establishes the Board of Certified Midwives to regulate the practice of midwifery in the District of Columbia. It establishes qualifications necessary to obtain a license to practice midwifery. It also permits Certified Professional Midwives to supervise services at a Maternity birthing center. Among other things it requires every maternity center to have written Practice Guidelines establishing procedures for both normal and emergency care.STATUS: The bill received a Public Hearing on June 22, 2018. See the video.

MSDC POSITIONS ON PAST DC LEGISLATION

Other Legislation

B21-38:Death with Dignity Act of 2015 BILL SUMMARY - As introduced, this bill establishes procedures and safeguards regarding the request for and dispensation of covered medications to qualified patients who are terminally ill and wish to die in a humane and dignified manner. The bill establishes dispensation and reporting requirements for physicians and the Department of Health. The legislation also defines its effect on contracts, wills, insurance and annuity policies and requires that they not be conditioned upon or affected by the making or rescinding of a request for medication or by a patient ingesting covered medication. It establishes terms for immunity from criminal and civil liabilities, establishes penalties and provides an opt-out provision for health care providers. It also provides for claims by the government for costs incurred from a patient terminating his or her life pursuant to the legislation in a public place.MSDC ACTION: The Board found that physician-assisted suicide and end-of-life care are complex issues with no clear consensus. The Board recognized the AMA position on physician-assisted suicide. The Board took no position on the bill.

B18-622:Legalization of Marijuana for Medical Treatment Amendment Act (Official Law went into effect July 27, 2010.)MSDC ACTION: The Medical Society endorsed the American Society of Addiction Medicine's position statement on medical marijuana. Read the Medical Society's letter.

Feel free to contact the Medical Society at 202-466-1800 with questions or comments about these or other topics.